Langzeitergebnisse der Behandlung des Morbus Perthes im floriden Stadium und nach Entwicklung einer Coxa magna mit der Beckenosteotomie nach Chiari

Abstract

We report about long term follow ups of treatment of Morbus Perthes with Chiari's Pelvic Osteotomy. Average follow up time was 8 years. One of our two main indications for operating was a distinct coxa magna with lack of sufficient roofing or with secondary osteoarthritis caused by this very lack. Cases with advanced destruction or strong lateralisation of the femoral head were the second major indication. Osteotomy as near to the joint as possible and extensive dislocation with maximal medialization of the head are the decisive factors for success for this operation. Two thirds of the cases showed a marked improvement of complaints at follow-up with almost unchanged range of motion. Improvement of the CE-angle and a remarkable increase of the sclerosed parts of the acetabular roof is also noticed in all x-rays at follow up. Nine cases can be judged as excellent, two as good and three as mediocre according to the cup-head-quotient of Heyman and Herndon. A remodelling of the femoral head with a Pelvic Osteotomy is possible even after conclusion of the reconstruction stage.